The use of mandibular homografts in reconstructing jaw defects

Abstract The history of mandibular restoration is reviewed, and the theories of bone regeneration are presented. The indications, techniques, and complications of deFries' method are discussed. deFries' technique involves packing a freeze‐dried mandibular shell with autogenous cancellous bone and marrow taken from the patient's iliac crest or rib. The method is especially helpful in restoring large mandibular defects in which the normal contours are difficult to restore with other grafting techniques. It is probably no better for small segmental defects than autogenous iliac crest, rib, or chrome‐cobalt cage packed with marrow. It should be avoided in: 1. patients who have received irradiation to the jaw or neck; 2. where there is a poor blood supply to these areas; and 3. in patients with anemia or poor nutritional status.